Advances in Fetal Echocardiography: Early Imaging, Three/Four Dimensional Imaging, and Role of Fetal Echocardiography in Guiding Early Postnatal Management of Congenital Heart Disease

In this article, we review a number of topics that we believe reflect new and exciting aspects of fetal echocardiography. These new advances include early fetal cardiovascular imaging around 14 weeks, the utility of three/four dimensional imaging technology for the fetus, and finally the utility of fetal echocardiography for antenatal and perinatal care of congenital heart diseases to improve and optimize outcome. Finally, we briefly discussed future directions in fetal cardiac intervention.

[1]  J. Karnell,et al.  Coarctation of the Aorta , 1968, Circulation.

[2]  S. Campbell,et al.  Echocardiographic and anatomical correlates in the fetus. , 1980, British heart journal.

[3]  G. Graham.  Congenital Diseases of the Heart , 1976 .

[4]  M. Burch,et al.  Prenatal diagnosis of coarctation of the aorta improves survival and reduces morbidity , 2002, Heart.

[5]  J. Cnota,et al.  Prediction and perinatal management of severely restrictive atrial septum in fetuses with critical left heart obstruction: clinical experience using pulmonary venous Doppler analysis. , 2011, The Journal of thoracic and cardiovascular surgery.

[6]  J. Rychik,et al.  Measurement of the Great Vessels in the Mediastinum Could Help Distinguish True From False‐Positive Coarctation of the Aorta in the Third Trimester , 2009, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[7]  C. Comstock,et al.  Collaborative Study on 4‐Dimensional Echocardiography for the Diagnosis of Fetal Heart Defects , 2010 .

[8]  J. Lock,et al.  Current status of fetal cardiac intervention. , 2010, Circulation.

[9]  N. Silverman,et al.  Echocardiographic techniques for assessing normal and abnormal fetal cardiac anatomy. , 1985, Journal of the American College of Cardiology.

[10]  Dev Maulik,et al.  Live Three‐Dimensional Echocardiography of the Human Fetus , 2003, Echocardiography.

[11]  D. Bonnet,et al.  Sensitivity and Specificity of Prenatal Features of Physiological Shunts to Predict Neonatal Clinical Status in Transposition of the Great Arteries , 2004, Circulation.

[12]  J. Towbin,et al.  How accurately, reproducibly, and efficiently can we measure left ventricular indices using M-mode, 2-dimensional, and 3-dimensional echocardiography in children? , 2008, American heart journal.

[13]  N. Silverman,et al.  Improved Surgical Outcome After Fetal Diagnosis of Hypoplastic Left Heart Syndrome , 2001, Circulation.

[14]  S. Colan,et al.  In utero pulmonary artery and aortic growth and potential for progression of pulmonary outflow tract obstruction in tetralogy of Fallot. , 1995, Journal of the American College of Cardiology.

[15]  V D Saini,et al.  Doppler evaluation of fetal hemodynamics. , 1982, Ultrasound in medicine & biology.

[16]  J. Oh,et al.  Feasibility of single-beat full-volume capture real-time three-dimensional echocardiography and auto-contouring algorithm for quantification of left ventricular volume: validation with cardiac magnetic resonance imaging. , 2011, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[17]  N. Silverman,et al.  Reversed shunting across the ductus arteriosus or atrial septum in utero heralds severe congenital heart disease. , 1996, Journal of the American College of Cardiology.

[18]  D J Sahn,et al.  Qualitative Real‐time Cross‐sectional Echocardiographic Imaging of the Human Fetus During the Second Half of Pregnancy , 1980, Circulation.

[19]  G. Rembouskos,et al.  Diagnosis of Congenital Heart Disease by Early and Second‐Trimester Fetal Echocardiography , 2012, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[20]  J. Huhta,et al.  Reactivity of the human fetal pulmonary circulation to maternal hyperoxygenation increases during the second half of pregnancy: a randomized study. , 1998, Circulation.

[21]  J. Rychik,et al.  Pulmonary outflow tract obstruction in fetuses with complex congenital heart disease: predicting the need for neonatal intervention , 2013, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[22]  W. Border,et al.  Predictive Value of Fetal Pulmonary Venous Flow Patterns in Identifying the Need for Atrial Septoplasty in the Newborn With Hypoplastic Left Ventricle , 2005, Circulation.

[23]  R. Fimmers,et al.  Early Fetal Echocardiography , 2006, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[24]  N. Nanda,et al.  Doppler Color Flow Mapping of the Fetal Heart , 1986, Angiology.

[25]  Hikoro Matsui,et al.  Morphological and Physiological Predictors of Fetal Aortic Coarctation , 2008, Circulation.

[26]  J. Hobbins,et al.  Echocardiographic studies of the human fetus: prenatal diagnosis of congenital heart disease and cardiac dysrhythmias. , 1980, Pediatrics.

[27]  R L Berkowitz,et al.  Fetal echocardiography: A tool for evaluation of in utero cardiac arrhythmias and monitoring of in utero therapy: Analysis of 71 patients , 1983 .

[28]  N. Silverman,et al.  Prenatal detection of congenital heart disease. , 2009, The Journal of pediatrics.

[29]  J. Lock,et al.  Results of in utero atrial septoplasty in fetuses with hypoplastic left heart syndrome , 2008, Prenatal diagnosis.

[30]  T. Scholz,et al.  Rapid full volume data acquisition by real-time 3-dimensional echocardiography for assessment of left ventricular indexes in children: a validation study compared with magnetic resonance imaging. , 2005, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[31]  L. Blieden,et al.  Intrauterine and Postnatal Atrial Fibrillation in the Wolff‐Parkinson‐White Syndrome , 1982, Circulation.

[32]  G. Mielke,et al.  Ductus arteriosus‐dependent pulmonary circulation secondary to cardiac malformations in fetal life , 1997, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[33]  M. Sharf,et al.  Intrauterine diagnosis and control of fetal ventricular arrhythmia during labor. , 1975, American journal of obstetrics and gynecology.

[34]  S. Goldberg,et al.  Quantitative real-time cross-sectional echocardiography in the developing normal humam fetus and newborn. , 1980, Circulation.

[35]  J. Xu,et al.  Comparison of real-time three-dimensional echocardiography and spatiotemporal image correlation in assessment of fetal interventricular septum , 2012, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[36]  J. Rychik,et al.  Perinatal and early surgical outcome for the fetus with hypoplastic left heart syndrome: a 5‐year single institutional experience , 2010, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[37]  K. Nicolaides,et al.  Fetal cardiac abnormalities identified prior to 14 weeks' gestation , 2002, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[38]  W. Arzt,et al.  Invasive intrauterine treatment of pulmonary atresia/intact ventricular septum with heart failure , 2003, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[39]  J Kachaner,et al.  Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality. , 1999, Circulation.

[40]  S. Colan,et al.  Changes in left heart hemodynamics after technically successful in‐utero aortic valvuloplasty , 2007, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[41]  J. Rychik,et al.  Vasoreactive Response to Maternal Hyperoxygenation in the Fetus With Hypoplastic Left Heart Syndrome , 2010, Circulation. Cardiovascular imaging.

[42]  N. Silverman,et al.  Fetal predictors of urgent balloon atrial septostomy in neonates with complete transposition. , 2011, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[43]  E. Bacha.  Impact of fetal cardiac intervention on congenital heart surgery. , 2011, Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual.

[44]  B. Thilaganathan,et al.  Clinical impact of first and early second trimester fetal echocardiography on high risk pregnancies , 2004, Heart.

[45]  M. Xie,et al.  Real Time Three‐Dimensional Echocardiography for Evaluation of Congenital Heart Defects: State of the Art , 2012, Echocardiography.

[46]  D. Valsky,et al.  Added value of three‐/four‐dimensional ultrasound in offline analysis and diagnosis of congenital heart disease , 2011, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[47]  H. Gardiner,et al.  Sonographic predictors of surgery in fetal coarctation of the aorta , 2012, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[48]  S. Yagel,et al.  Three- and Four-Dimensional Imaging in Fetal Echocardiography , 2012 .

[49]  D. Chitayat,et al.  Early fetal echocardiography--a reliable prenatal diagnosis tool. , 2005, American journal of obstetrics and gynecology.

[50]  G. Marx,et al.  In Utero Valvuloplasty for Pulmonary Atresia With Hypoplastic Right Ventricle: Techniques and Outcomes , 2009, Pediatrics.

[51]  E. Gratacós,et al.  Accuracy of four‐dimensional spatiotemporal image correlation echocardiography in the prenatal diagnosis of congenital heart defects , 2010, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[52]  S. A. Levine,et al.  Coarctation of the aorta; a review of 104 autopsied cases of the adult type, 2 years of age or older. , 1947, American heart journal.

[53]  C. Wren,et al.  Twenty-year trends in diagnosis of life-threatening neonatal cardiovascular malformations , 2007, Archives of Disease in Childhood Fetal and Neonatal Edition.

[54]  J. Simpson,et al.  An echocardiographic study of tetralogy of Fallot in the fetus and infant , 2003, Cardiology in the Young.

[55]  G. Marx,et al.  Predictors of Technical Success and Postnatal Biventricular Outcome After In Utero Aortic Valvuloplasty for Aortic Stenosis With Evolving Hypoplastic Left Heart Syndrome , 2009, Circulation.